SPORT PSYCHOLOGY - SEPTEMBER 24, 2018

Featured Interview: Andrew Crome

Andrew Cromeis the mental performance consultant at Mind to Muscle and Sports Medicine and Rehabilitation, with offices located in Barrie and Orillia. He grew up competing in various sports, most notably swimming. His love of sport led him to complete a Bachelor’s degree in Sports Studies and a Master’s degree in Psychology of Sport, where he specialized in rehabilitation from injury and fear of re-injury respectively.

He has since been working with athletes in order to improve their mental strength and help them bridge the gap between good and great. Andrew has also been a member of the Toronto Marathon Psyching Team for the past three years, where they provide runners with mental tips before, during, and after the race.

1) Can you share the story of how you landed in the field of sport psychology?

I first got exposed to Sport Psychology during my Bachelor’s degree, where I undertook some classes in it. The more I learned about it, the more I realized that I could’ve been a much better swimmer if I was taught mental skills when I was competing. This was a major factor in why I completed my Masters in Psychology of Sport. I wanted to show athletes the benefits of mental training and how it may be the missing piece of their game. Sport Psychology has really grown in the past 20 years and more and more athletes are openly speaking about their work with Sport Psychologists, which is great to see as it’s starting to be seen as a vital part of sport rather than a weakness.

As I previously mentioned, I specialized in fear of re-injury during my Masters. The reason for this is because I dislocated my knee when I was about 14 and I had some trouble getting back to competing again. I had lost most of the muscle in my right leg and also knew that the chances of re-dislocation were high. I was proved right as I dislocated it again during a routine jump during a soccer match. It took me some time to get to a point where I was no longer fearful of re-injuring my knee, which I came to learn is very normal. I also learned ways of reducing this fear that I now pass on to the athletes I work with.

2) What type of athletes do you work with, and how often do you see them?

I mostly work with youth athletes in various sports such as; swimming, hockey, soccer, gymnastics, skiing, baseball, and equestrian. I do team sessions as well as individual sessions. The team sessions usually consist of a discussion and exercises of mental skills that can be applied to the chosen sport. We also set team goals for the season and do various team-building exercises.

My individual sessions are more specific to the athlete and we work together to establish a mental training program. I find that it’s imperative to include the athlete in the decision making process as it gives them ownership over their training program. I generally see my athletes every few weeks but it varies due to how they’re performing and what stage of the season it is. Every few weeks works well, especially at the beginning stages as we can change things if they aren’t working and slowly add exercises until they have a training program that covers the 5 C’s (Confidence, Concentration, Commitment, Communication, Control).

3) What are some of the biggest factors in preventing athletes from making a comeback? What are the most common concerns?

For me, the major factors at play in coming back from injury are the motivation and the beliefs of the athlete. The beliefs of the athlete will usually determine their level of motivation to get through their rehabilitation and get back to the level they were at prior to injury.

If an injured athlete believes that they have lost their strength and stamina, it is easy for them to start feeling sorry for themselves and start to believe that their career is over. They might be thinking. “I’ll never get back to the level I was before” or, “My competitors are getting better and I’m getting worse.” These beliefs will likely decrease the motivation needed to get through a gruelling rehab program. On the other hand, if the athlete believes that they will comeback as strong or even stronger than they were before injury, then they will do whatever it takes to get that strength and stamina back, and ultimately make a successful comeback.

Trust in the injured area is also a common concern, even if the athlete has been passed fit to return to their sport. Thoughts such as, “what if my knee isn’t strong enough?” or “I hope I don’t injure it again” are common ones to go through an athlete’s mind as they make their comeback. Studies show that having a lack of trust in the injured area increases the risk of re-injury. For example, an athlete, in an attempt to prevent re-injury, may enter an unnatural position or tense up when encountering contact. The athlete may do this subconsciously, as the brain’s main function is to keep us safe from harm, perceived or real. This shows us that being physically ready to return doesn’t necessarily mean that it should happen immediately. The mentality of the athlete must be considered and they should be eased back into their sport at their own pace in order to reduce the chances of re-injury.

4) What advice would you give to athletes who are recovering from an injury who feel a sense of loss of athletic-identity?

Make rehabilitation your new sport. Approach the recovery process like any other athletic challenge and take it head-on without giving way to fear and doubt. Set goals for yourself just like you do within your sport and set out to smash those.

A huge part of athletic-identity is the social aspect so a good way of maintaining that identity when injured is to be around your peers or teammates. You can still go to the gym with them and train parts of your body. You can still socialize with them and watch them compete, which should increase the motivation for you to recover. I think one of the biggest mistakes you can make is to remove yourself from your sporting environment just because of injury.

5) Can you share some mental exercises and skills that will be beneficial in the comeback from injury?

One exercise that can be very beneficial is to keep a journal. Write, in detail, about every exercise and rehab session you do. This includes physiotherapy and chiropractic appointments as well as gym workouts. Write how you felt before, during and after the sessions and what the session entailed. Consider what went well and what you need to keep working on. Just keep a notebook or diary in your bag and write everything down before you forget the details! The reason for doing this is so you can look back at all the hard work you’ve done in order to get back to full fitness and health. If you ever feel like you haven’t done enough rehab or are worried about returning to action, look back at your journal and then you’ll see proof of everything you’ve done. I suggest that you read through the journal every week to keep that much needed motivation and confidence flowing.

Mental imagery is perhaps the perfect mental skill to practice as you go through rehab and start your comeback. I would use mental imagery in two ways; to aid the healing process and to see yourself performing in your chosen sport.

In ancient healing and spiritual traditions, the power of positive mental attitude and the use of imagery were often major parts of the healing process and this has now been shown to be the case. In fact, an NFL wide receiver suffered a thumb injury and recovered in half the expected time. One reason for this could be due to the use of imagery. He imagined that there was a construction site inside his thumb and there were construction workers working away to fix it.

I suggest that once a day, you find a quiet and comfortable place to sit or lie and take as many deep breaths (4 seconds inhale and 4 seconds exhale) as needed in order to feel completely relaxed. Then spend a few minutes imagining the injured area healing, becoming stronger, and returning to normal. You can also imagine an ice pack or healing colours surrounding the injured area when you experience pain from the injury.

You may not be able to physically practice your sport but you can mentally practice and keep your mental athletic abilities sharp as you wait for your physical abilities to return. Your brain doesn’t know the difference between what’s real or imaginary. This is why you jump during a scary movie or wake up in a panic during a nightmare. So if you imagine yourself performing, your brain will store it as if you physically performed.

Diver Laura Wilkinson broke three bones in her foot just before the 200 U.S. Olympic trials. While she was unable to dive for two months during her recovery, she imagined ripping her dives each day. She ended up not only qualifying for the Olympics, but also won a gold medal even though her foot was not fully healed. That shows the power of the brain!

Again, go to your quiet and comfortable place and get relaxed. Imagine yourself performing how you would like to perform, using all of your senses to make it as vivid as possible. What do you see around you? What and who do you hear? What can you smell? What can you feel? (e.g. hard tarmac under feet or bat in your hands). Is there anything that you can taste? (e.g. sweat). You’ll notice that the more you practice this, the more vivid your images will become.

6) Are there any final words that you would like to share with athletes that you think would be helpful for their road to recovery?

You don’t have to go through the long and often painful journey alone. Establish a support network of friends, family, and medical professionals and talk with them on a regular basis. People will be willing to help you out if you ask for it.

Also, have patience and persistence. If you under-do your rehabilitation, you could either prolong the recovery or re-injure yourself. Do what the medical professionals recommend and don’t overdo it in the hope that you’ll recover faster. If you trust the process to deliver the results you want, it likely will. Ride the waves and stay positive!

7) What are the various ways that injuries affect the minds of athletes?

Fear of re-injury and depressive symptoms are two major hurdles that an injured athlete may have to encounter.

Fear of re-injury, also known as re-injury anxiety, is the most commonly cited reason by athletes for not returning to sport post ACL surgery. Fear of re-injury is defined as an irrational and debilitating fear or anxiety that physical movements will result in painful re-injury. Fear of re-injury is often accompanied by diminished concentration and self-confidence, as well as an increase in distractibility and pain awareness. This can contribute to athletes falling into a cycle of inactivity leading to reduced strength and flexibility, and ultimately avoidance of activity.

In terms of depressive symptoms, these can vary based on the injury, limits to mobility and length of rehabilitation. Symptoms can arise just after the injury, which may be due to frustration and feelings of injustice or shock associated with the injury. However, symptoms can also be delayed and could be associated with feeling socially isolated, loss of skills or opportunities, and absence from training or competition, which can lead to a loss of athletic identity.